Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy C Vandevender, PT

Individual provider Physical Therapist · NPI 1487691416

Jeremy C Vandevender, PT is a Physical Therapist in Staten Island, New York. Licensed in New Jersey and New York. Registered with an NPI since 2006.

Licensed in
NJ, NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

4434 Amboy Rd
Staten Island, NY 10312-3866
Phone: (718) 227-7015
Fax: (718) 227-6411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 021302-1 (NY)
Physical Therapist Taxonomy 225100000X · Licence 40QA00972700 (NJ)

Record details

NPI number1487691416
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 31, 2006
Last updated in NPPESNovember 10, 2009

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